Transverse connector

ABSTRACT

A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end, a second coupling assembly proximate a second end, a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor, and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface, such as a spherically concave upper surface. A spherical surface of each of the first and second coupling assemblies mates with the spherical upper surface of the respective fastener to provide multi-axial rotation of the transverse connector relative to the housings to permit a desired orientation of the transverse connector.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 13/041,031, filed on Mar. 4, 2011, the entire disclosure of which is incorporated herein by reference.

TECHNICAL FIELD

The disclosure is directed to transverse connectors for use in a spinal stabilization system. More particularly, the disclosure is directed to transverse connectors which may be attached between vertebral anchors in a spinal stabilization system.

BACKGROUND

The spinal column is a highly complex system of bones and connective tissues that provides support for the body and protects the delicate spinal cord and nerves. The spinal column includes a series of vertebrae stacked one on top of the other. Each vertebra includes a vertebral body including an inner or central portion of relatively weak cancellous bone and an outer portion of relatively strong cortical bone. An intervertebral disc is situated between each vertebral body to cushion and dampen compressive forces experienced by the spinal column. A vertebral canal, called the foramen, containing the spinal cord and nerves is located posterior to the vertebral bodies. In spite of the complexities, the spine is a highly flexible structure, capable of a high degree of curvature and twist in nearly every direction. For example, the kinematics of the spine normally includes flexion, extension, rotation and lateral bending.

There are many types of spinal column disorders including scoliosis (abnormal curvature and twisting of the spine), kyphosis (abnormal forward curvature of the spine, usually in the thoracic spine), excess lordosis (abnormal backward curvature of the spine, usually in the lumbar spine), spondylolisthesis (forward displacement of one vertebra over another, usually in a lumbar or cervical spine) and other disorders caused by abnormalities, disease, or trauma, such as ruptured or slipped discs, degenerative disc disease, fractured vertebra, and the like. Patients that suffer from such conditions usually experience extreme and debilitating pain as well as diminished range of motion and nerve function. These spinal disorders may also threaten the critical elements of the nervous system housed within the spinal column.

In some instances, a spinal stabilization system may be installed on a segment of the spinal column to stabilize a portion of the spinal column to treat a spinal disorder. One particular spinal stabilization technique includes immobilizing portions of the spine of a patient by using elongate members such as relatively rigid orthopedic spinal rods that run generally parallel to the spine on opposite sides of the spinous processes. Another technique utilizes less rigid elongate members to provide a more dynamic stabilization of the affected regions of the spine. One example of such a spinal stabilization system is the Dynesys® system available from, Zimmer Spine, Inc., of Minneapolis, Minn.

Installation of such systems may be accomplished, for example, by accessing the spine posterially and fastening hooks, bone screws, or other types of vertebral anchors to the pedicles or other bony structures of the appropriate vertebrae. The vertebral anchors may be generally placed in a quantity of two per vertebra, one on either side of the spinous processes, and serve as anchor points for the elongate members.

It may be desirable in some circumstances to provide a cross connector, such as a transverse connector, to bridge across the spinal column from a first assembly of vertebral anchors and associated elongate member to a second assembly of vertebral anchors and associated elongate member of the spinal stabilization system to provide additional stability to the spinal stabilization system. Accordingly, there exists a need to provide alternative transverse connector assemblies which may be coupled between first and second vertebral anchors of a spinal stabilization system.

SUMMARY

The disclosure is directed to several alternative designs, materials and methods of manufacturing medical device structures and assemblies.

Accordingly, one illustrative embodiment is a transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system. The transverse connector includes a first coupling assembly proximate a first end of the transverse connector and a second coupling assembly proximate a second end of the transverse connector. The transverse connector also includes a first fastener having external threading configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor and a second fastener having external threading configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper surface. A spherical surface of the first coupling assembly mates with the spherical upper surface of the first fastener and a spherical surface of the second coupling assembly mates with the spherical upper surface of the second fastener.

Another illustrative embodiment is a spinal stabilization system including first, second, third and fourth vertebral anchors, each including a housing and a bone engagement portion extending from the housing, with a first elongate member extending between the first and third vertebral anchors and a second elongate member extending between the second and fourth vertebral anchors. The spinal stabilization system further includes a first fastener securing the first elongate member in a channel of the housing of the first vertebral anchor and a second fastener securing the second elongate member in a channel of the housing of the second vertebral anchor. Each of the first and second fasteners includes a spherical upper portion having a spherically convex surface and a threaded lower portion threadably engaging the housing of the respective vertebral anchor. The spinal stabilization system also includes a transverse connector including a first coupling housing proximate a first end of the transverse connector and a second coupling housing proximate a second end of the transverse connector. The first coupling housing includes an aperture therethrough for receiving the spherical upper portion of the first fastener and the second coupling housing includes an aperture therethrough for receiving the spherical upper portion of the second fastener. Each aperture has a concave annular sidewall configured to mate with the spherically convex surface of the spherical upper portion of the respective fastener to allow rotational movement therebetween.

The above summary of some example embodiments is not intended to describe each disclosed embodiment or every implementation of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention may be more completely understood in consideration of the following detailed description of various embodiments in connection with the accompanying drawings, in which:

FIG. 1 is a perspective view of an exemplary spinal stabilization system including a transverse connector extending between vertebral anchors;

FIG. 2 is a perspective view of the transverse connector shown in FIG. 1;

FIG. 3 is a cross-sectional view of the transverse connector of FIG. 1;

FIG. 4 is an enlarged perspective view of components of a coupling portion of the transverse connector of FIG. 2;

FIG. 5 is a cross-sectional view of components of the coupling portion shown in FIG. 4;

FIG. 6 is a cross-sectional view of the components of the coupling portion assembled together;

FIG. 7 is a cross-sectional view of the transverse connector of FIG. 2 taken through line 7-7;

FIG. 8 is a perspective view of another transverse connector for use in a spinal stabilization system;

FIG. 9 is a cross-sectional view of the transverse connector of FIG. 8;

FIG. 10 is an enlarged perspective view of components of a coupling portion of the transverse connector of FIG. 8;

FIG. 11 is a cross-sectional view of components of the coupling portion shown in FIG. 10;

FIG. 12 is a top view of the set screw of the transverse connector of FIG. 8;

FIG. 13 is a perspective view of another transverse connector for use in a spinal stabilization system;

FIG. 14 is a cross-sectional view of the transverse connector of FIG. 13;

FIG. 15 is an enlarged perspective view of components of a coupling portion of the transverse connector of FIG. 13;

FIG. 16 is a perspective view of yet another transverse connector for use in a spinal stabilization system;

FIG. 17 is a cross-sectional view of the transverse connector of FIG. 16;

FIG. 18 is a perspective view of another transverse connector for use in a spinal stabilization system; and

FIG. 19 is a cross-sectional view of the transverse connector of FIG. 18.

While the invention is amenable to various modifications and alternative forms, specifics thereof have been shown by way of example in the drawings and will be described in detail. It should be understood, however, that the intention is not to limit aspects of the invention to the particular embodiments described. On the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention.

DETAILED DESCRIPTION

For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.

All numeric values are herein assumed to be modified by the term “about”, whether or not explicitly indicated. The term “about” generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the term “about” may be indicative as including numbers that are rounded to the nearest significant figure.

The recitation of numerical ranges by endpoints includes all numbers within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).

Although some suitable dimensions, ranges and/or values pertaining to various components, features and/or specifications are disclosed, one of skill in the art, incited by the present disclosure, would understand desired dimensions, ranges and/or values may deviate from those expressly disclosed.

As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.

The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The detailed description and the drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the invention. The illustrative embodiments depicted are intended only as exemplary. Selected features of any illustrative embodiment may be incorporated into an additional embodiment unless clearly stated to the contrary.

Now referring to the drawings, an exemplary spinal stabilization system 2 for stabilizing a portion of a spinal column, such as one or more spinal segments of a spinal column, is illustrated in FIG. 1. As used herein, a spinal segment is intended to refer to two or more vertebrae, the intervertebral disc(s) between the vertebrae and other anatomical elements between the vertebrae. For example, a spinal segment may include first and second adjacent vertebrae and the intervertebral disc located between the first and second vertebrae. The spinal stabilization system 2 may provide support to the spinal segment subsequent bone fusion, may help preserve the facet joints between adjacent vertebrae by providing facet offloading and/or may stabilize or reverse neural foraminal narrowing of the spinal column, in some instances.

In some embodiments, the spinal stabilization system 2 may be used to treat discogenic low back pain, degenerative spinal stenosis, disc herniations, facet syndrome, posterior element instability, adjacent level syndrome associated with spinal fusion, and/or other maladies associated with the spinal column.

The spinal stabilization system 2 may include one or more or a plurality of vertebral anchors 10. Although the vertebral anchors 10 are depicted as threaded vertebral fasteners (e.g., pedicle screws, bone screws), in some embodiments the vertebral anchors 10 may be vertebral hooks (e.g., laminar hooks) or other types of fastening members for attachment to a bony structure such as a vertebra of the spinal column. Each of the vertebral anchors 10 may be configured to be secured to a vertebra of a spinal column.

The spinal stabilization system 2 may be used in any desired region of the spinal column, such as the cervical, thoracic, thoracolumbar, and lumbar regions. The vertebral stabilization system 2 may be installed multi-laterally on opposite sides of the sagittal plane of the spinal column, with the first and third vertebral anchors 10 a, 10 c and the first elongate member 4 positioned on one lateral side of the sagittal plane and the second and fourth vertebral anchors 10 b, 10 d and the second elongate member 4 positioned on the other lateral side (i.e., contra-lateral side) of the sagittal plane. For instance, the first vertebral anchor 10 a and the second vertebral anchor 10 b may be secured to a first vertebra on contra-lateral sides of the sagittal plane, while the third vertebral anchor 10 c and the fourth vertebral anchor 10 d may be secured to a second vertebra on contra-lateral sides of the sagittal plane. Additional vertebral anchors 10 may be secured to additional vertebrae as desired.

The vertebral anchor 10 may include a housing 12 and a bone engagement portion, such as a bone screw 14 extending from the housing 12 along a longitudinal axis of the vertebral anchor 10. In some embodiments, the vertebral anchor 10 may be a monoaxial screw in which the housing 12 is stationary relative to the bone screw 14, while in other embodiments the vertebral anchor 10 may be a polyaxial screw in which the housing 12 is actuatable (e.g., pivotable) relative to the bone screw 14. In some embodiments, the bone screw 14 may be configured to be installed into a bony region of a vertebra of the spinal column. For example, the bone screw 14 may be installed into a pedicle of a vertebra, or other region of a vertebra. In some embodiments, the bone screw 14 may include helical threads configured to be screwed into a pedicle of a vertebra, or other bony region of a vertebra.

The housing 12 may include a base portion and first and second legs 8 extending from the base portion and defining a channel 6, such as a U-shaped channel, therebetween extending into the housing 12 from an upper extent of the housing 12 opposite the bone screw 14. In some embodiments each of the first and second legs 8 may include a threaded portion for threadedly engaging a threaded portion of a fastener. In other embodiments, the first and second legs 8 may include other engagement features for engaging with a securing member positioned in the housing 12 between the first and second legs 8.

The spinal stabilization system 2 may also include one or more, or a plurality of elongate stabilization members 4, such as elongate rods, extending between vertebral anchors 10 of the spinal stabilization system 2. As an illustrative example, the spinal stabilization system 2 shown in FIG. 1 includes a first elongate member 4 extending between and secured to the first vertebral anchor 10 a and the third vertebral anchor 10 c, and a second elongate member 4 extending between and secured to the second vertebral anchor 10 b and the fourth vertebral anchor 10 d.

The elongate members 4 may be secured in the channels 6 of the housings 12 of the vertebral anchors 10 using threaded fasteners or other securement members. For instance, threaded set screws 15 may be threadably engaged with the threaded portions of the legs 8 of the housings 12 of the third and fourth vertebral anchors 10 c, 10 d and press against the elongate member 4 to secure the elongate members 4 in the channels 6.

The spinal stabilization system 2 may also include a transverse connector 20 which may be positioned generally perpendicular to the elongate members 4 to provide additional stability to the spinal stabilization system 2 in some instances. The transverse connector 20 may be configured to be coupled to the housings 12 of contra-laterally positioned vertebral anchors 10. For example, the transverse connector 20 may be coupled between the first and second vertebral anchors 10 a, 10 b in an orientation generally perpendicular to the elongate members 4. The transverse connector 20 may include fasteners 40 having external threading configured to threadably engage an internal threaded portion of the housing 12 between the legs 8 of a vertebral anchor 10. The fasteners 40 may press against the elongate member 4 to secure the elongate members 4 in the channels 6 of the housings 12 of the first and second vertebral anchors 10 a, 10 b.

In some instances, it may be desirable to install the transverse connector 20 between vertebral anchors 10 on a single side of the spinal column, thus the transverse connector 20 may extend generally parallel to the elongate member 4 coupled between adjacent vertebral anchors 10. For instance, the elongate member 4 may be coupled to the first and third vertebral anchors 10 a, 10 c on a single side of the sagittal plane of the spinal column, with the transverse connector 20 also secured to and extending between the first and third vertebral anchors 10 a, 10 c on the same side of the sagittal plane of the spinal column. Thus, the transverse connector 20 may extend parallel to the elongate member 4 in a vertical direction generally parallel with the longitudinal axis of the spinal column.

Additional features and components of the transverse connector 20 are further illustrated in FIGS. 2-7. As shown in FIG. 2, the transverse connector 20 may include a first connector member 22 and a second connector member 24 coupled together. For instance, the first connector member 22, which may be considered a male connector member, may include a coupling housing 26 and an elongate extension 28 extending from the coupling housing 26. Furthermore, the second connector member 24, which may be considered a female connector member, may include a coupling housing 26 and an elongate extension 30 extending from the coupling housing 26. The elongate extension 30 may include a receiver 34 with an opening 36 therethrough for receiving the elongate extension 28 of the first connector member 22.

The transverse connector 20 may be configured such that the first connector member 22 may be moved in multiple degrees of freedom relative to the second connector member 24. For example, the first connector member 22 may translate along a longitudinal axis (see arrow A, FIG. 2) and rotate about the longitudinal axis (see Arrow B, FIG. 7) relative to the second connector member 24, in some instances. In some embodiments, the transverse connector 20 may include additional degrees of freedom, such as pivot about an axis transverse to the longitudinal axis. When the first connector member 22 is positioned at a desired orientation relative to the second connector member 24, the locking screw 38, threadably engaged in a threaded bore of the receiver 34, may be rotated into engagement against the elongate extension 28 of the first connector member 22 to apply a clamping force between the first connector member 22 and the second connector member 24 to thereby prevent further movement therebetween.

Referring to FIG. 7, the locking screw 38 may include a protuberance 37, which may be a spherical protuberance, extending into an elongate recess 32 of the elongate extension 28 of the first connector member 22. The arcuate lower surface of the protuberance 37, the arcuate surface of the recess 32 and the arcuate lower wall of the opening 36 may share a common center of curvature. Thus, as can be seen by the arrow B, the elongate extension 28 of the first connector member 22 may rotate about the common center of curvature relative to the second connector member 24 to adjust the orientation of the first connector member 22 relative to the second connector member 24. As shown in FIG. 3, the recess 32 may include end surfaces which limit the longitudinal travel of the protuberance 37 in the recess 32, and thus prevent decoupling of the first connector member 22 from the second connector member 24.

The transverse connector 20 may include coupling assemblies 80 configured to secure the transverse connector 20 to the housings 12 of vertebral anchors 10. As shown in FIG. 3, a first coupling assembly 80 proximate the first end of the transverse connector 20 may couple the transverse connector 20 to a first vertebral anchor 10 and a second coupling assembly 80 proximate the second end of the transverse connector 20 may couple the transverse connector 20 to a second vertebral anchor 10.

Turning now to FIG. 4, a coupling assembly 80 of the transverse connector 20 will be further described. It is noted that although one coupling assembly 80 at one end of the transverse connector 20 is described herein, the coupling assembly 80 at the other end of the transverse connector 20 may be similarly configured and include similar components.

The coupling assembly 80 may include the coupling housing 26, the fastener 40, and a set screw 50 configured to threadably engage a threaded bore 46 of the fastener 40. The fastener 40 may include external threading configured to threadably engage an internal threaded portion of the housing 12 of a vertebral anchor 10, and a spherical upper surface. For instance, the fastener 40 may include a lower threaded portion 42 including the external threading and an upper spherical portion 44 including a spherically convex surface 56. In some instances, the fastener 40 may be a monolithic member including the upper spherical portion 44 and the lower threaded portion 42.

The upper spherical portion 44 may include a plurality of convex segments 48 with slots 49 therebetween radially arranged. The presence of the slots 49 between adjacent segments 48 may permit the segments 48 of the upper spherical portion 44 to flex or deflect relative to each other.

The upper spherical portion 44 may be configured to be positioned in the aperture 52 of the coupling housing 26 such that the spherically convex surface 56 faces and mates with a spherically concave annular sidewall 54 of the aperture 52. Thus, the aperture 52 may receive the upper spherical portion 44 of the fastener 40 therein to permit rotational movement therebetween. As shown in FIG. 6, the set screw 50 may be threadably disposed in the threaded bore 46 to exert a radially outward force F on the convex segments 48 of the upper spherical portion 44 to press the spherically convex surface 56 against the spherically concave surface of the annular sidewall 54 to lock the upper spherical portion 44 in the aperture 52 and prevent further rotational movement therebetween. In some instances, the set screw 50 and the fastener 40 may be configured such that the force F exerted on the convex segments 48 from the set screw 50 is substantially radially outward, without appreciable force being generated axially.

One possible configuration of the threading of the set screw 50 and the threading of the threaded bore 46 of the fastener 40 which achieves a substantially radially outward force F is illustrated at FIG. 5. In this embodiment, the set screw 50 includes an external thread 60 having a major diameter D1 that is constant from an upper portion of the set screw 50 to a lower portion of the set screw 50, and a minor diameter that tapers from a larger diameter D2 proximate the upper portion of the set screw 50 to a smaller diameter D3 proximate the lower portion of the set screw 50. Thus the height of the thread 60 increases from the upper portion to the lower portion of the set screw 50 while the major diameter D1 remains substantially constant.

Furthermore, in this embodiment, the threaded bore 46 of the upper spherical portion 44 of the fastener 40 includes an internal thread 70 that has a major diameter D4 that is constant from an upper portion of the threaded bore 46 to a lower portion of the threaded bore 46, and a minor diameter that tapers from a larger diameter D5 proximate the upper portion of the threaded bore 46 to a smaller diameter D6 proximate the lower portion of the threaded bore 46. Thus the height of the thread 70 increases from the upper portion of the threaded bore 46 to the lower portion of the threaded bore 46 while the major diameter D4 remains substantially constant.

The thread 60 of the set screw 50 may be configured such that the upper flank 62 of the thread 60 is perpendicular to the central longitudinal axis of the set screw 50 and the lower flank 64 of the thread 60 is perpendicular to the central longitudinal axis of the set screw 50. Thus, the upper flank 62 may be parallel to the lower flank 64. Furthermore, the crest 66 of the thread 60 may be perpendicular to the upper and lower flanks 62, 64 and the root 68 of the thread 60 may be perpendicular to the upper and lower flanks 62, 64. Thus, the crest 66 and/or root 68 of the thread 60 may be parallel to the central longitudinal axis of the set screw 50.

Similarly, the thread 70 of the threaded bore 46 may be configured such that the upper flank 72 of the thread 70 is perpendicular to the central longitudinal axis of the threaded bore 46 and the lower flank 74 of the thread 70 is perpendicular to the central longitudinal axis of the threaded bore 46. Thus, the upper flank 72 may be parallel to the lower flank 74. Furthermore, the crest 76 of the thread 70 may be perpendicular to the upper and lower flanks 72, 74 and the root 78 of the thread 70 may be perpendicular to the upper and lower flanks 72, 74. Thus, the crest 76 and/or root 78 of the thread 70 may be parallel to the central longitudinal axis of the threaded bore 46.

Such a configuration may provide positive engagement between the thread 60 of the set screw 50 and the thread 70 of the threaded bore 46 even at the onset of threading the set screw 50 into the threaded bore 46. In other words, the thread 60 may engage the thread 70 as the set screw 50 initially enters the threaded bore 46. As the set screw 50 is continued to be threaded into the threaded bore 46, the root 68 of the thread 60 of the set screw 50 presses against the crest 76 of the thread 70 of the threaded bore 46, exerting a radially outward force F normal to the surfaces of the root 68 and crest 76 on the convex segments 48 of the upper spherical portion 44 of the fastener 40, which in turn presses the convex segments 48 against the concave sidewall 54 of the coupling housing 26, as shown in FIG. 6. Due to the perpendicular orientation of the flanks 62/64, 72/74 and the parallel orientation of the crests 66/76 and roots 68/78 relative to the central longitudinal axes, no appreciable force is generated other than in a direction perpendicular to the central longitudinal axis.

Referring again to FIG. 3, in use, the transverse connector 20 may be coupled between first and second vertebral anchors 10. Initially, the first and second vertebral anchors 10 may be secured to a vertebra, followed by positioning an elongate member 4 in the channel 6 of the housing 12 of each of the vertebral anchors 10. With the elongate member 4 in the channel 6 of the housing 12, the fastener 40 may be threaded into the threaded opening in the housing 12 between the legs 8 of the housing 12 to secure the elongate member 4 in the channel 6. For example, the fastener 40 may include an internal driver interface 45, such as a hex socket, or other driver interface for receiving a driver to rotatably advance the fastener 40 against the elongate member 4. In some instances, the vertebral anchor 10 may include a seat 5 against which the elongate member 4 is pressed against to transfer a locking force to the head 16 of the bone screw 14 to lock the housing 12 from further pivotable movement relative to the bone screw 14. In other instances, the elongate member 4 may be pressed directly against the head 16 of the bone screw 14. This process may be followed to secure each of the elongate members 4 to the housing 12 of the respective vertebral anchor 10.

If not already coupled to the fastener 40, the first connector member 22 may then be coupled to the upper spherical portion 44 of the fastener 40 secured to the first vertebral anchor 10 a and/or the second connector member 24 may be coupled to the upper spherical portion 44 of the fastener 40 secured to the second vertebral anchor 10 b. The spherical interface between the spherically convex surface 56 of the upper spherical portion 44 and the spherically concave sidewall 54 of the aperture 52 of the coupling housing 26 allows for multi-axial rotation of the transverse connector 20 relative to the housings 12 to permit a desired orientation of the transverse connector 20.

With the coupling housing 26 properly oriented around the upper spherical portion 44, the set screw 50 may be threadably engaged in the threaded bore 46 of the fastener 40 to apply a radially outward locking force F between the spherically convex surface 56 of the upper spherical portion 44 and the spherically concave sidewall 54 of the aperture 52 of the coupling housing 26. This may be repeated for each end of the transverse connector 20 to fixedly lock the transverse connector 20 to the housing 12 of each vertebral anchor 10.

The locking screw 38 may also be tightened once the desired orientation between the first connector member 22 and the second connector member 24 is achieved to fix the first connector member 22 to the second connector member 24. As shown in FIG. 3, when the transverse connector 20 is secured to the housings 12 of the vertebral anchors 10, the first and second connector members 22, 24 may be spaced away from direct contact with the housings 12 of the vertebral anchors 10 such that there is a gap between the upper extent of the housings 12 and the coupling housings 26.

Another transverse connector 120, which may be coupled between the first and second vertebral anchors 10 a, 10 b is shown in FIG. 8. The transverse connector 120 may include a first connector member 122 and a second connector member 124 coupled together. For instance, the first connector member 122, which may be considered a male connector member, may include a coupling housing 126 and an elongate extension 128 extending from the coupling housing 126. Furthermore, the second connector member 124, which may be considered a female connector member, may include a coupling housing 126 and an elongate extension 130 extending from the coupling housing 126. The elongate extension 130 may include a receiver 134 with an opening 136 therethrough for receiving the elongate extension 128 of the first connector member 122.

The transverse connector 120 may be configured such that the first connector member 122 may be adjustable relative to the second connector member 124. For example, the first connector member 122 may translate along a longitudinal axis relative to the second connector member 124, in some instances. When the first connector member 122 is positioned at a desired orientation relative to the second connector member 124, the locking screw 138, threadably engaged in a threaded bore of the receiver 134, may be rotated into engagement against the elongate extension 128 of the first connector member 122 to apply a clamping force between the first connector member 122 and the second connector member 124 to thereby prevent further movement therebetween.

Referring to FIG. 9, the locking screw 138 may include a protuberance 137 extending into an elongate recess 132 of the elongate extension 128 of the first connector member 122. The recess 132 may include end surfaces which limit the longitudinal travel of the protuberance 137 in the recess 132, and thus prevent decoupling of the first connector member 122 from the second connector member 124.

The transverse connector 120 may include coupling assemblies 180 configured to secure the transverse connector 120 to the housings 12 of vertebral anchors 10. As shown in FIG. 9, a first coupling assembly 180 proximate the first end of the transverse connector 120 may couple the transverse connector 120 to a first vertebral anchor 10 a and a second coupling assembly 180 proximate the second end of the transverse connector 120 may couple the transverse connector 120 to a second vertebral anchor 10 b.

Turning now to FIG. 10, a coupling assembly 180 of the transverse connector 120 will be further described. It is noted that although one coupling assembly 180 at one end of the transverse connector 120 is described herein, the coupling assembly 180 at the other end of the transverse connector 120 may be similarly configured and include similar components.

The coupling assembly 180 may include the coupling housing 126, a threaded fastener 142, a spherical member 144, and a tapered screw 160 configured to threadably engage a threaded bore 145 of the fastener 142. The fastener 142 may include external threading configured to threadably engage an internal threaded portion of the housing 12 of a vertebral anchor 10 to secure an elongate member 4 in the channel 6 of the housing 12. The upper surface of the fastener 142 may be a spherically concave upper surface 143.

The spherical member 144 may include a plurality of convex segments 148 with slots 149 therebetween radially arranged. The presence of the slots 149 between adjacent segments 148 may permit the segments 148 of the spherical member 144 to flex or deflect relative to each other.

The spherical member 144 may be configured to be positioned in the aperture 152 of the coupling housing 126 such that the spherically convex surface 156 faces and mates with a spherically concave annular sidewall 154 of the aperture 152. Thus, the aperture 152 may receive the spherical member 144 therein to permit rotational movement therebetween. The spherically convex surface 156 is also configured to rest against and mate with the spherically concave surface 143 of the fastener 142.

As shown in FIG. 11, a tapered screw 160 may be inserted through the bore 146 of the spherical member 144 such that a threaded portion 164 of the tapered screw threadably engages the threaded bore 145 of the fastener 142. A tapered head portion 162 of the tapered screw 160 may contact a tapered surface 163 of the bore 146 of the spherical member 144 to exert a radially outward force on the convex segments 148 of the spherical member 144 when the tapered screw 160 is threadedably engaged with the fastener 142. The tapered screw 160 may include an internal driver interface 161, such as a hex socket, or other driver interface for receiving a driver to rotatably advance the tapered screw 160 into the threaded bore 145 such that the tapered head portion 162 presses against the tapered surface 153 of the bore 146.

Referring again to FIG. 9, in use, the transverse connector 120 may be coupled between first and second vertebral anchors 10. Initially, the first and second vertebral anchors 10 may be secured to a vertebra, followed by positioning an elongate member 4 in the channel 6 of the housing 12 of each of the vertebral anchors 10. With the elongate member 4 in the channel 6 of the housing 12, the fastener 142 may be threaded into the threaded opening in the housing 12 between the legs 8 of the housing 12 to secure the elongate member 4 in the channel 6. For example, the fastener 142 may include an internal driver interface, such as a hex socket, or other driver interface formed in the threaded bore 145 for receiving a driver to rotatably advance the fastener 142 against the elongate member 4.

As shown in FIG. 12, the bore 145 may be configured with hexagonal sidewalls 149 defining the internal driver interface for receiving a hex wrench. The threading of the bore 145 may be configured such that the major diameter 147 of the internal threading of the bore 145 circumscribes the hexagonal sidewalls 149, while the minor diameter 165 of the threaded portion 164 of the tapered screw 160 would be inscribed within the hexagonal sidewalls 149. It is contemplated that the driver interface may be otherwise configured into the bore 145 while preserving the internal threading for threadably receiving the threaded portion 164 of the tapered screw 160.

The spherical member 144, rotatably coupled in the coupling housing 126 of the first connector member 122 and/or the second connector member 124, may then be positioned against the spherically concave upper surface 143 of the fastener 142 secured to the respective vertebral anchor 10. The spherical interface between the spherically convex surface 156 of the spherical member 144 and the spherically concave sidewall 154 of the aperture 152 of the coupling housing 126 allows for multi-axial rotation of the transverse connector 120 relative to the housings 12 to permit a desired orientation of the transverse connector 120.

With the spherically convex surface 156 of the spherical member 144 positioned against the spherically concave upper surface 143 of the fastener 142, the tapered screw 160 may be advanced through the bore 146 of the spherical member 144 and threadably engaged in the threaded bore 145 of the fastener 142 to apply a radially outward locking force F between the spherically convex surface 156 of the spherical member 144 and the spherically concave sidewall 154 of the aperture 152 of the coupling housing 126. This may be repeated for each end of the transverse connector 120 to fixedly lock the transverse connector 120 to the housing 12 of each vertebral anchor 10.

The locking screw 138 may also be tightened once the desired orientation between the first connector member 122 and the second connector member 124 is achieved to fix the first connector member 122 to the second connector member 124. As shown in FIG. 9, when the transverse connector 120 is secured to the housings 12 of the vertebral anchors 10, the first and second connector members 122, 124 may be spaced away from direct contact with the housings 12 of the vertebral anchors 10 such that there is a gap between the upper extent of the housings 12 and the coupling housings 126.

Another transverse connector 220, which may be coupled between the first and second vertebral anchors 10 a, 10 b is shown in FIG. 13. The transverse connector 220 may include a first coupling housing 226, a second coupling housing 226 and a cross member 222 pivotably coupled to each of the coupling housings 226 at a pivot point, such as at pins 224.

The transverse connector 220 may include coupling assemblies 280 configured to secure the transverse connector 220 to the housings 12 of vertebral anchors 10. As shown in FIG. 14, a first coupling assembly 280 proximate the first end of the transverse connector 220 may couple the transverse connector 220 to a first vertebral anchor 10 a and a second coupling assembly 280 proximate the second end of the transverse connector 220 may couple the transverse connector 220 to a second vertebral anchor 10 b.

Turning now to FIG. 15, a coupling assembly 280 of the transverse connector 220 will be further described. It is noted that although one coupling assembly 280 at one end of the transverse connector 220 is described herein, the coupling assembly 280 at the other end of the transverse connector 220 may be similarly configured and include similar components.

The coupling assembly 280 may include the coupling housing 226, a threaded fastener 242, and a threaded screw 260 configured to extend through the elongated opening 230 and threadably engage a threaded bore 245 of the fastener 242. The fastener 242 may include external threading configured to threadably engage an internal threaded portion of the housing 12 of a vertebral anchor 10 to secure an elongate member 4 in the channel 6 of the housing 12. The upper surface of the fastener 242 may be a spherically concave upper surface 243.

The coupling housing 226 may include an upper surface 228 such as a spherically concave surface, a lower surface 229 such as a spherically convex surface, and an aperture extending through the coupling housing 226 from the upper surface 228 to the lower surface 229. In some instances, the aperture may be an elongated opening 230 having a width W and a length L greater than the width W. The elongated opening 230 may include partial threading 232 along a portion of the sidewall of the elongated opening 230. For example, each of two opposing sidewalls of the elongated opening 230 may include discontinuous threads.

The threaded screw 260 may include a head 262 having a driver interface 261 and a shank extending from the head 262 having a threaded lower portion 264 and an unthreaded upper portion 266. The threaded lower portion 264 may be sized to pass through the elongate opening 230 of the coupling housing 226 only by way of the partial threads 228 of the elongate opening 230. In other words, the major diameter of the threaded lower portion 264 may be greater than the width W of the elongate opening 230 such that the threaded lower portion 264 cannot pass freely through the elongate opening 230 in an axial direction without being rotatably threaded through the partial threaded portion of the elongated opening 230. The unthreaded upper portion 266 may have a diameter less than the width W of the elongated opening 230 such that once the lower threaded portion 264 is threaded through the elongated opening 230, the unthreaded upper portion 266 (which is now positioned in the elongated opening 230) may freely travel back and forth along the length L of the elongated opening 230 to any desired position.

Referring again to FIG. 14, in use, the transverse connector 220 may be coupled between first and second vertebral anchors 10. Initially, the first and second vertebral anchors 10 may be secured to a vertebra, followed by positioning an elongate member 4 in the channel 6 of the housing 12 of each of the vertebral anchors 10. With the elongate member 4 in the channel 6 of the housing 12, the fastener 242 may be threaded into the threaded opening in the housing 12 between the legs 8 of the housing 12 to secure the elongate member 4 in the channel 6. For example, similar to the fastener 142 discussed above, the fastener 242 may include an internal driver interface, such as a hex socket, or other driver interface formed in the threaded bore 245 for receiving a driver to rotatably advance the fastener 242 against the elongate member 4.

The spherically convex lower surface 229 of the coupling housing 226 may then be positioned against the spherically concave upper surface 243 of the fastener 242 secured to the respective vertebral anchor 10, and the threaded screw 260 (extending through the elongated opening 230) may be threaded into the threaded bore 245 of the fastener 242. The spherical interface between the spherically convex lower surface 229 of the coupling housing 226 and the spherically concave upper surface 243 of the fastener 242 allows for multi-axial rotation of the transverse connector 220 relative to the housings 12 while the unthreaded upper portion 266 of the threaded screw 260 travels along the elongated opening 230 to permit a desired orientation of the transverse connector 220. In some instances, the under side of the head 262 of the threaded screw 260 may be spherically convex to mate with the spherically concave upper surface 228 of the coupling housing 226. The spherical interfaces and elongated opening 230, along with the pivotable connection between the coupling housing 226 and the cross member 222, may allow for a desired degree of lateral adjustability of the transverse connector 220.

Once in a desired orientation with the spherically convex lower surface 229 of the coupling housing 226 positioned against the spherically concave upper surface 243 of the fastener 242, the threaded screw 260 may be rotated in the threaded bore 245 of the fastener 242 to apply a locking force between the spherically convex lower surface 229 of the coupling housing 226 and the spherically concave upper surface 243 of the fastener 242 to lock the coupling housing 226 from further movement relative to the housing 12. This may be repeated for each end of the transverse connector 220 to fixedly lock the transverse connector 220 to the housing 12 of each vertebral anchor 10.

As shown in FIG. 14, when the transverse connector 220 is secured to the housings 12 of the vertebral anchors 10, the coupling housings 226 of the transverse connector 220 may be spaced away from direct contact with the housings 12 of the vertebral anchors 10 such that there is a gap between the upper extent of the housings 12 and the coupling housings 226.

Yet another transverse connector 320, which may be coupled between the first and second vertebral anchors 10 is shown in FIG. 16. The transverse connector 320 may include a first connector member 322 and a second connector member 324 coupled together. For instance, the first connector member 322, which may be considered a male connector member, may include a first spherical member 348 and an elongate extension 328 extending from the first spherical member 348. Furthermore, the second connector member 324, which may be considered a female connector member, may include a second spherical member 348 and an elongate extension 330 extending from the second spherical member 348. The elongate extension 330 may include a receiver 334 with an opening extending therein for receiving the elongate extension 328 of the first connector member 322.

The transverse connector 320 may be configured such that the first connector member 322 may be adjustable relative to the second connector member 324. For example, the first connector member 322 may translate along a longitudinal axis relative to the second connector member 324, in some instances. When the first connector member 322 is positioned at a desired orientation relative to the second connector member 326, the locking screw 338, threadably engaged in a threaded bore of the receiver 334, may be rotated into engagement against the elongate extension 328 of the first connector member 322 to apply a clamping force between the first connector member 322 and the second connector member 324 to thereby prevent further movement therebetween.

The transverse connector 320 may include coupling assemblies 380 configured to secure the transverse connector 320 to the housings 12 of vertebral anchors 10. As shown in FIG. 17, a first coupling assembly 380 proximate the first end of the transverse connector 320 may couple the transverse connector 320 to a first vertebral anchor 10 a and a second coupling assembly 380 proximate the second end of the transverse connector 320 may couple the transverse connector 320 to a second vertebral anchor 10 b.

A coupling assembly 380 may include the spherical member 348, a threaded fastener 342, and a threaded nut 346 configured to threadably engage a threaded upper portion of the fastener 342. The fastener 342 may also include a lower portion having external threading configured to threadably engage an internal threaded portion of the housing 12 of a vertebral anchor 10 to secure an elongate member 4 in the channel 6 of the housing 12. The upper surface of the fastener 342 may be a spherically concave upper surface 343.

The threaded nut 346 may surround at least a portion of the spherical member 348 with the extension 328/330 extending through a bore 350 of the threaded nut 346. The spherical member 348 may be sized larger than the bore 350 of the threaded nut 346 such that the spherical member 348 cannot pass through the bore 350. A sidewall of the bore 350 of the nut 346 may be configured to engage a portion of the spherical member 348 when the threaded nut 346 is tightened onto the fastener 342.

The spherical member 348 may include a spherically convex surface 356 configured to rest against and mate with the spherically concave surface 343 of the fastener 342 to provide multi-axial rotational orientation therebetween.

In use, the transverse connector 320 may be coupled between first and second vertebral anchors 10. Initially, the first and second vertebral anchors 10 may be secured to a vertebra, followed by positioning an elongate member 4 in the channel 6 of the housing 12 of each of the vertebral anchors 10. With the elongate member 4 in the channel 6 of the housing 12, the fastener 342 may be threaded into the threaded opening in the housing 12 between the legs 8 of the housing 12 to secure the elongate member 4 in the channel 6. For example, the fastener 342 may include an internal driver interface 345, such as a hex socket, or other driver interface for receiving a driver to rotatably advance the fastener 342 against the elongate member 4.

The spherical member 348 may then be positioned against the spherically concave upper surface 343 of the fastener 342 secured to the respective vertebral anchor 10. The spherical interface between the spherically convex surface 356 of the spherical member 348 and the spherically concave upper surface 343 allows for multi-axial rotation of the transverse connector 320 relative to the housings 12 to permit a desired orientation of the transverse connector 320.

With the spherically convex surface 356 of the spherical member 348 positioned against the spherically concave upper surface 343 of the fastener 342, the threaded nut 346 may be threadably engaged onto the threaded upper portion of the fastener 342 to apply a locking force between the spherically convex surface 356 of the spherical member 348 and the spherically concave upper surface 343 of the fastener 342. This may be repeated for each end of the transverse connector 320 to fixedly lock the transverse connector 320 to the housing 12 of each vertebral anchor 10.

The locking screw 338 may also be tightened once the desired orientation between the first connector member 322 and the second connector member 324 is achieved to fix the first connector member 322 to the second connector member 324. As shown in FIG. 17, when the transverse connector 320 is secured to the housings 12 of the vertebral anchors 10, the first and second connector members 322, 324 may be spaced away from direct contact with the housings 12 of the vertebral anchors 10 such that there is a gap between the upper extent of the housings 12 and the threaded nuts 346.

In some instances, it may be desirable to provide a transverse connector having a first end including a coupling assembly for coupling to a housing 12 of a vertebral anchor 10 and a second end including a coupling assembly for coupling directly to an elongate member 4. One such example of a transverse connector 420, which may be coupled between a vertebral anchor 10 and an elongate member 4 is shown in FIG. 18. The transverse connector 420 may include a first connector member 422 and a second connector member 424 coupled together. Similar to transverse connectors discussed above, the transverse connector 420 may be configured such that the first connector member 422 may be adjustable relative to the second connector member 424. When the first connector member 422 is positioned at a desired orientation relative to the second connector member 424, the locking screw 438, threadably engaged in a threaded bore of the receiver 434, may be rotated into engagement against the elongate extension 428 of the first connector member 422 to apply a clamping force between the first connector member 422 and the second connector member 424 to thereby prevent further movement therebetween. It is noted that, alternatively, the receiver 434 may be associated with the first connector member 422 and the elongate extension 428 may be associated with the second connector member 424, or the first and second connector members 422, 424 may otherwise be configured to be adjustably secured to another.

The transverse connector 420 may include a coupling assembly at one end of the transverse connector 420 configured to secure the first end of the transverse connector 420 to the housing 12 of a vertebral anchor 10 and a dissimilar coupling assembly at the other end of the transverse connector 420 configured to secure the second end of the transverse connector 420 to the elongate member 4.

The first coupling assembly 480 at the first end of the transverse connector 420 may be similar to one of the coupling assemblies described above in regards to the transverse connectors 20, 120, 220, 320. For example, as illustrated the first coupling assembly 480 may be similar to the coupling assembly 80 of the transverse connector 20, although the coupling assembly 480 may alternatively be constructed similar to the coupling assemblies 180, 280, 380, or other desired construction. Although the first coupling assembly 480 is shown associated with the second connector member 424, in other embodiments the first coupling assembly 480 may be associated with the first connector member 422.

As shown in FIG. 19, the first coupling assembly 480 may include a coupling housing 426, a fastener 440, and a set screw 450 configured to threadably engage a threaded bore of the fastener 440. The fastener 440 may include external threading configured to threadably engage an internal threaded portion of the housing 12 of the vertebral anchor 10, and a spherical upper surface. For instance, the fastener 440 may include a lower threaded portion 442 including the external threading and an upper spherical portion 444 including a plurality of convex segments 448 with slots therebetween radially arranged which are flexible or deflectable relative to each other.

The upper spherical portion 444 may be configured to be positioned in the aperture of the coupling housing 426 such that the spherically convex surface of the upper spherical portion 444 faces and mates with a spherically concave annular sidewall of the aperture to permit rotational movement therebetween. The set screw 450 may be threadably disposed in the threaded bore to press the convex segments 448 against the coupling housing 426 to lock the upper spherical portion 444 in the aperture and prevent further rotational movement therebetween.

The second coupling assembly 490 at the second end of the transverse connector 420 may be configured to be secured directly to an elongate member 4. For instance, as shown in FIG. 19, the second coupling assembly 490 may include a coupler 492 having a pair of deflectable arms 491 and a threaded portion 494. The coupler 492 may be disposed in a bore of a coupling housing 496. A threaded fastener 498 may be threadably engaged with the threaded portion 494 of the coupler 492. The deflectable arms 491 may be configured to be deflected around the elongate member 4 to couple the elongate member 4 thereto. Although the second coupling assembly 490 is shown associated with the first connector member 422, in other embodiments the second coupling assembly 490 may be associated with the second connector member 424.

In use, the first coupling assembly 480 of the transverse connector 420 may be coupled to the vertebral anchor 10 as described above. Turning to the second coupling assembly 490, the second coupling assembly 490 of the transverse connector 420 may be coupled to the elongate member 4 by first inserting the elongate member 4 into the cavity between the deflectable arms 491. In some instances the elongate member 4 may snap into the cavity between the deflectable arms 491 to provisionally lock the elongate member 4 to the second coupling assembly 490. The threaded fastener 498, threadably engaged with the threaded portion 494 of the coupler 492, may then be rotated to draw the coupler 492 upward into the cavity of the coupling housing 496. As the coupler 492 is drawn upward in the coupling housing 496, the deflectable arms 491 may press against the coupling housing 496 in the bore to clamp onto the elongate member 4, thereby securing the coupling housing 490 to the elongate member 4.

Referring to any of the preceding embodiments, in some instances a locking feature may be included to prevent the threaded fastener (e.g., fastener 40, 142, 242, 342, 440) from backing out of the housing 12 of the vertebral anchor 10 when subjected to torque exerted by the transverse connector through spinal movement. For instance, an engaging member (e.g., setscrew 50, 450, threaded screw 160, 260 or spherical member 348) may be pressed against a feature of the fastener to deform the threads to lock the fastener in place. One of skill in the art will recognize that other locking features may be used to lock the threaded fastener from backing out of the housing 12 once assembled. For instance, the coupling housings may include features designed to insert into or otherwise interact with the channels 6 of the housing 12 or other feature of the housing 12 to prevent relative rotational movement therebetween.

Those skilled in the art will recognize that the present invention may be manifested in a variety of forms other than the specific embodiments described and contemplated herein. Accordingly, departure in form and detail may be made without departing from the scope and spirit of the present invention as described in the appended claims. 

What is claimed is:
 1. A transverse connector for coupling between first and second vertebral anchors of a spinal stabilization system, the transverse connector comprising: a first coupling assembly proximate a first end of the transverse connector, the first coupling assembly including: a first coupling housing having an upper surface, a lower surface, and an elongated opening extending from the upper surface to the lower surface of the first coupling housing; a first fastener positionable through the elongated opening of the first coupling housing, the first fastener including a first threaded portion configured to threadably engage an internal threaded portion of a housing of the first vertebral anchor; and a third fastener including a threaded portion configured to threadably engage a second threaded portion of the first fastener; a second coupling assembly proximate a second end of the transverse connector, the second coupling assembly including: a second coupling housing having an upper surface, a lower surface, and an elongated opening extending from the upper surface to the lower surface of the second coupling housing; a second fastener positionable through the elongated opening of the second coupling housing, the second fastener including a first threaded portion configured to threadably engage an internal threaded portion of a housing of the second vertebral anchor; and a fourth fastener including a threaded portion configured to threadably engage a second threaded portion of the second fastener; wherein the first coupling housing of the transverse connector is positionable at a plurality of angular positions relative to a longitudinal axis of the housing of the first vertebral anchor; and wherein the second coupling housing of the transverse connector is positionable at a plurality of angular positions relative to a longitudinal axis of the housing of the second vertebral anchor.
 2. The transverse connector of claim 1, wherein the first fastener is configured to secure a first elongate member in the housing of the first vertebral anchor and the second fastener is configured to secure a second elongate member in the housing of the second vertebral anchor.
 3. The transverse connector of claim 2, wherein a lower surface of the first fastener is configured to press against the first elongate member in the housing of the first vertebral anchor, and a lower surface of the second fastener is configured to press against the second elongate member in the housing of the second vertebral anchor.
 4. The transverse connector of claim 1, wherein the first fastener and the third fastener are rotatable about the longitudinal axis of the housing of the first vertebral anchor.
 5. The transverse connector of claim 4, wherein the second fastener and the fourth fastener are rotatable about the longitudinal axis of the housing of the second vertebral anchor.
 6. The transverse connector of claim 1, wherein: the first fastener includes a driver socket extending into the first fastener from an upper surface of the first fastener to accommodate a driver instrument for threadably engaging the first fastener in the internal threaded portion of the housing of the first vertebral anchor, and the second fastener includes a driver socket extending into the second fastener from an upper surface of the second fastener to accommodate a driver instrument for threadably engaging the second fastener in the internal threaded portion of the housing of the second vertebral anchor.
 7. The transverse connector of claim 6, wherein: the third fastener extends above the upper surface of the first fastener when threadably engaged to the second threaded portion of the first fastener, and the fourth fastener extends above the upper surface of the second fastener when threadably engaged to the second threaded portion of the second fastener.
 8. The transverse connector of claim 7, wherein: the third fastener includes a head portion having a spherical lower surface, and the threaded portion of the third fastener extends from the spherical lower surface of the third fastener; and the fourth fastener includes a head portion having a spherical lower surface, and the threaded portion of the fourth fastener extends from the spherical lower surface of the fourth fastener.
 9. The transverse connector of claim 8, wherein: the third fastener includes a driver socket extending into the head portion of the third fastener from an upper surface of the head portion of the third fastener to accommodate a driver instrument for threadably engaging the third fastener with the first fastener; and the fourth fastener includes a driver socket extending into the head portion of the fourth fastener from an upper surface of the head portion of the fourth fastener to accommodate a driver instrument for threadably engaging the fourth fastener with the second fastener.
 10. The transverse connector of claim 8, wherein: the spherical lower surface of the third fastener is matingly engageable with a spherical surface of the first coupling assembly; and the spherical lower surface of the fourth fastener is matingly engageable with a spherical surface of the second coupling assembly.
 11. The transverse connector of claim 8, wherein: the spherical lower surface of the third fastener is a convex spherical surface; and the spherical lower surface of the fourth fastener is a convex spherical surface.
 12. The transverse connector of claim 1, wherein: the second threaded portion of the first fastener is an internal threaded portion; and the second threaded portion of the second fastener is an internal threaded portion.
 13. The transverse connector of claim 1, wherein: an upper portion of the first fastener including the second threaded portion has an outer diameter and a lower portion of the first fastener including the first threaded portion has an outer diameter different than the outer diameter of the upper portion of the first fastener; and an upper portion of the second fastener including the second threaded portion has an outer diameter and a lower portion of the second fastener including the first threaded portion has an outer diameter different than the outer diameter of the upper portion of the second fastener.
 14. The transverse connector of claim 1, wherein: the first fastener is translatable in the elongated opening of the first coupling housing in a direction generally transverse to a rotational axis of the first fastener; and the second fastener is translatable in the elongated opening of the second coupling housing in a direction generally transverse to a rotational axis of the second fastener. 